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Residential Sign Up
135 NW Harold Drive, PO Box 619, Pullman, WA 99163
(509) 334-1914
contact@pullmandisposal.com
Download Form PDF
Residential Sign Up
Customer's Name
(Required)
First
Middle
Last
Additional Contact
First
Middle
Last
Service Address
(Required)
Street Address
Address Line 2
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Street Address
Address Line 2
City
Alabama
Alaska
American Samoa
Arizona
Arkansas
California
Colorado
Connecticut
Delaware
District of Columbia
Florida
Georgia
Guam
Hawaii
Idaho
Illinois
Indiana
Iowa
Kansas
Kentucky
Louisiana
Maine
Maryland
Massachusetts
Michigan
Minnesota
Mississippi
Missouri
Montana
Nebraska
Nevada
New Hampshire
New Jersey
New Mexico
New York
North Carolina
North Dakota
Northern Mariana Islands
Ohio
Oklahoma
Oregon
Pennsylvania
Puerto Rico
Rhode Island
South Carolina
South Dakota
Tennessee
Texas
Utah
U.S. Virgin Islands
Vermont
Virginia
Washington
West Virginia
Wisconsin
Wyoming
Armed Forces Americas
Armed Forces Europe
Armed Forces Pacific
State
ZIP Code
Primary Phone Number
(Required)
Secondary Number
Email Address
(Required)
Would you like paperless billing?
(Required)
Yes
No
Have you ever had service with us in your name?
(Required)
Yes
No
Name the account it was under and the service address
(Required)
Check all that apply:
(Required)
Resident
Owner
Landlord
Manager
Are you paying for more than one unit?
(Required)
Yes
No
Please check one:
(Required)
House/Single Residence
Duplex
Tri-plex
Four-plex
If you are within city limits, do you have a recycling cart?
(Required)
Yes
No
Do you want a recycling cart?
(Required)
Yes
No
Is there anything else you would like us to know?
Read & Sign
I hereby authorize collection service at the above address. If I should move, I authorize this agreement to be valid at the new residence. Everything I have filled in is true and complete to the best of my knowledge. I promise to pay for the collection service. I agree to pay all collection agency fees, attorney fees, court costs and any other out of pocket costs, if I should default.
Signature
(Required)
Signing Date
(Required)
Month
Day
Year
Service Start Date
Month
Day
Year
Waste Collection
For smaller can sizes, contact the office
Start Date
(Required)
Month
Day
Year
Size of can(s)
(Required)
Check one
1-32 gal can/rollcart
64 gal cart (2 Reg. Cans)
96 gal cart (3 Reg. Cans)
Yard Waste Collection
This is optional
Yes
No
Size of can
Check one
64 gal cart
96 gal cart
